Context of Obamacare must be recalled in fight over its possible successor

Noah M. Horwitz

It cannot be overstated that Obamacare is a mockup of both Mitt Romney’s plan as governor of Massachusetts and the Heritage Foundation in the 1990s. Barack Obama sparred with Hillary Clinton in the 2008 Democratic primaries over what eventually became Obamacare and if it was too conservative. Obama essentially wished to co-opt the right’s plan with some adjustments as an act of good faith to the right and of bipartisanship. The plan was successful ­— the bipartisanship, not so much.

This context of Obamacare’s inception is critical to understanding the current impasse on healthcare policy. The Republican Party’s hitherto failure to come up with a cogent argument for any of their abominations of a healthcare bill is precisely because Obama stole their play book.

Simply put, there are two feasible methods by which universal coverage, an ostensible bipartisan goal, can be achieved — government or market. Obamacare forces the latter through a byzantine system of controls and mandates. The alternative is single-payer.

The Republican plans, most recently penned by Sens. Bill Cassidy, R-La., and Lindsey Graham, R-S.C., simply rip up the reform and return to the status quo antebellum we had before Obamacare, wherein those with pre-existing conditions could be denied coverage or charged significantly higher rates.

Cassidy-Graham removes protections for those with pre-existing conditions, notwithstanding the lies told by its authors and the president. At the heart of Obamacare is making sure these folks could get the care they needed. Cassidy-Graham, as well as its predecessors, undo this, as well as the Medicaid expansion, which has helped those in most of need.

Such changes in law are simply a value judgment; caring about a specific policy outcome regardless of the externalities. Obamacare is not a panacea, and in many cases, actively harms people. However, the rough consensus of a majority of the country is that help for the poor people on Medicaid and with pre-existing conditions outweighs the very real harm that manifests itself in higher premiums for some, higher taxes for others (admittedly the wealthy) and higher inconvenience for physicians in some cases. Republicans disagree with that consensus.

But to say that the Republican plans are a good faith effort to achieve universal coverage is simply not true. The economics and specifics of Obamacare have been repeated in grander detail in places more deserving than my column, but the odious parts of the law (individual mandate and taxes) pay for and otherwise structurally support the popular parts of the law (no limits on coverage and pre-existing conditions). To pretend that you can have your cake and eat it too is disgustingly disingenuous.

A more cynical conclusion might be that Republicans care little about policy specifics and simply want to deliver red meat to their base by way of dismantling the legacy of Obama. Either way, we must remember the context in which Obamacare, which was RomneyCare before it and HeritageCare before that, was created. The best way to defang the lies being retold to the American people in our incumbent debate on the matter at hand is to remember that.                     

Horwitz is a second-year law student from Houston. He is senior columnist.